Quotes from KAISER MENTAL HEALTH CLINICIANS:
“I have seen patients pay out-of-pocket and go privately for services that should be covered under the health plan…”
-Kaiser MFT (5 years on the job)
“[P]atients…have changed therapists, because they are hoping for more frequent appointments with a different provider. That does not happen, because no therapist in the clinic has more frequent appointments.”
-Kaiser Psych Social Worker (32 years on the job)
Downey
“I have more and more patients saying they are complaining to Member Services about frequency of return appointments. I have others choosing to go to private practitioners. The worst moments are when I have intakes with mental health professionals (psych techs, county social workers, MSWs, MFTs, PhDs, and attimes MDs) who look at me and say “You mean I can only see you every 4-5 weeks? How is that ethical?”
-Kaiser LCSW (10 years on the job)
Downey
“The mother of a patient who just turned 18 told me that her son waited a full week after discharge from the hospital after a suicide attempt to see the psychiatrist and a couple more weeks prior to seeing a therapist.”
-Kaiser Psychologist, (15 years on the job)
Fresno
“I feel pressure to work faster and faster. There is no time to breathe, think, or do any creative brain-storming for clinical planning or program development. I see gaps in services at our department that historically I would be professionally interested in developing and I am too fatigued and burned out to put myself out there.”
-Kaiser LCSW (10 years on the job)
Downey
“[Patients] have to wait so long that they give up. They often call and utilize crisis services as they are unable to wait for their regularly scheduled appointments 4-6 weeks out.”
-Kaiser LCSW (Northern California)
“Many patients are unhappy with our one size fits all combo of group treatment with occasional individual check-ins….We spend a lot of resources trying to lower patients expectations when they come to our clinic. The orientation to our department is specifically about that. Many patientsdon’t return after the first visit because of this. This is not surprising given the subtext of most treatment encounters, which is ‘how can I get this patient out of my schedule as quickly as possible?’”
-Kaiser Psychologist (Northern California)
“Numerous patients will not even schedule an intake [appointment] because they are so far out…They get discouraged and give up on the entire process. Some [patients] have stated to me that they are not getting their “money’s worth with Kaiser”. Most are very disappointed in the long wait times to get in and then return.”
-Kaiser MFT (Northern California)
“More often than not, during an intake, I have patients very upset when I tell them my next available appointment, and they often ask for referrals outside of Kaiser. When I tell them this is not a covered Kaiser benefit, I often get asked how it is that they pay for a mental health benefit, yet when they need help, they cannot receive the services unless they pay for it out of pocket. To this, I offer them group therapy once a week, which many of them are not appropriate for…”
-Psychologist (Northern California)
“[We] need to stay within model of care for offering new intake appointments. If we are not within the model our Department ispunished monetarily. To keep within the standard with our low staffing requires offering more intakes then there are return appointments to accommodate with in the required standard. We are constantly juggling limited resources to be able to meet patient needs and not have needed money taken away from our clinic.
-Kaiser LCSW (Northern California)
“The negative impact is observed everyday when a patient calls our office and desperately wants an appointment but has to wait 4-8 weeks to get in to see someone. I see Seniors and they often have limited resources in regard to transportation and access.[Many] are struggling with significant medical issues as well as cognitive slowing, dementia, onset of Alzheimer’s. They are significantly impacted by our poor access.”
-Kaiser LCSW (Southern California)
“I am aware of a patient on my caseload that was unable to get in quickly to see me. She overdosed and was hospitalized after a familymember found her. I don’t know if the appointment would have forestalled the incident but I think patient would have been assessed if she came in.”
-Kaiser MFT (Southern California)
“I have one woman coming in for marital issues but due to not being seen has now started having panic attacks, resulting in a visit to the ER, and depression.”
-MFT (Southern California)
“One patient I worked with last year could not get in a timely fashion and he became seriously depressed and suicidal again. Today I Spoke w a woman on the phone because I hadn’t seen her in some time and was worried about her. She told me she could not get an appointment with me for 6 weeks when she called in. She was severely depressed and crying today, and was very suicidal yesterday. I made arrangements to add her to my schedule.”
-Kaiser MFT (Southern California)
“…some patients that could have been promptly and effectively helped with regular brief weekly sessions that are NOT available may become more distressed. Patients have also complained that unless they INSIST they are suicidal, they may have to wait for weeks to be seen.”
-Kaiser LCSW (Southern California)
“Unless these patients are suicidal, or gravely disabled, and eligible for the Intensive Outpatient Program, they have to wait for appointments and are usually put in groups.”
-Kaiser LCSW (Northern California)
“Patients with under treatment or aborted treatment for mental health issues often cost more in the long run because of the increase in high cost medical issues when mental health concerns are not adequately addressed. We could save huge dollars across the medical center if we adequately addressed mental health issues in a more proactive, long term fashion…”
-Kaiser Psychologist (Northern California)
“Two suicides in 14 months by a gun to the head.”
-Kaiser MFT (Northern California)
“One of many of which I am aware. Therapist said patient would receive a call to check in and for scheduling another appt. Patient contemplating suicide. No call came. Suicide attempt very close to being made. A chance interruption. “
-Kaiser Psychologist (Northern California)
“I have had two particular cases of late that had negative outcomes with DCFS [Department of Children and Family Services] because they were not able to have the frequency of visits that DCFS and the family court was expecting. In one case, I was confronted by a DCFS worker that they were having a meeting to determine whether or not to remove children and that the DCFS team was appalled by the frequency of visits at Kaiser plus what appeared to be poor communication and coordination of care between the KMHCinpatient, KMHC PHP, and outpatient psychiatry (that those three tx [treatment] teams had no access to each others notes or dates of tx nor was there cleardischarge summaries or hand-offs to each level of care). This lack ofcoordination at first made it seem like the patient was lying about her treatment attendance when actually it was in part my fault as I had no access to the dates of treatment for the other programs.”
-Kaiser LCSW (Southern California)
Quote from a KAISER MENTAL HEALTH PATIENT:
“My therapist had requested to see me as often as I can get an appointment. She was disappointed that it takes me so long and that my appointments are averaging once a month but I can tell her hands are tied and there is nothing she cando. As I said before, this isn’t a new problem. This has been going on with Kaiser, in my experience, for at least 5-7 years.”
-Kaiser Mental Health Patient
Woodland Hills